[Treatment of undeveloped external intestinal fistulas].
135 patients with undeveloped intestinal fistulas (116-85.9%-males, and 19-14.1%-females) were followed up by the authors. The patients underwent surgery for acute appendicitis-17 (12.6%), traumatic injuries of abdominal organs-78 (57.8%), acute intestinal obstruction-33 (24.4%), inflammatory processes of the uterus and adnexites-7 (5.2%). Small bowel fistulas were observed in 88 (65.2%) of patients, large bowel fistulas-in 47 (34.8%). The optimal mode of treatment for the fistula seems the obturation of fistula duct by means of catheter of Petzer of Foley. It is guite necessary to perform a simultaneous broad exploration of abscesses of anterior abdominal wall and their sanatation by the method of flowing-aspiration therapy by N.N. Kanshin. For elimination of endotoxicosis the ultraviolet irradiation of autologous blood was used as well as intravenous laser irradiation of blood, hemosorption, plasmapheresis, infusions of plasma and plasma substitutional solutions. The patients were given 2-3 antibiotics of a broad spectrum of action, one of which being obligatory introduced intravenously. From 135 patients 104 (77.0%) underwent surgery. The method of choice in small bowel fistulas the authors suggest intraabdominal resection of the bowel, and in large bowel fistulas-resection of 3/4 by the method of A.V. Melnikov. 17 patients (17.3%) died after the surgery.
Nikhinson
R A
RA
Department of Surgical Diseases, Medical Institute, Krasnoiarsk.
Fil'kin
G N
GN
D000328:Adult; D000900:Anti-Bacterial Agents; D001804:Blood Transfusion, Autologous; D002404:Catheterization; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000628:therapy; D007412:Intestinal Fistula / Q000209:etiology / Q000628:therapy*; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D010956:Plasmapheresis; D013396:Suction; D016896:Treatment Outcome; D014467:Ultraviolet Therapy
D000900:Anti-Bacterial Agents
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